State-based health-insurance exchanges are to play a key role in transforming the nation’s health care and insurance industries under The Patient Protection and Affordable Care Act, better known as Obamacare. The exchanges are designed to serve as markets for individuals and small business to shop for private insurance coverage, under greatly enlarged federal regulations.

Each state can decide for itself whether or not to create its own exchange. And nearly 20 states — after weighing the expected costs and bureaucratic nightmares involved in the exchanges — have already told the Obama administration, in so many words, to take their exchanges and dump them in a bedpan.

Georgia is the latest state to do so.

“We have no interest in spending our tax dollars on an exchange that is state-based in name only,” declared Gov. Nathan Deal in a press release Nov. 16. “I would support a free market-based approach that could serve as a useful tool for Georgia’s small businesses, but federal guidelines forbid that. Instead, restrictions on what the exchanges can and can’t offer render meaningless the suggestion that Georgia could tailor an exchange that best fits the unique needs of its population.”

Deal went on to cite the unknown costs of such exchanges, their lack of flexibility and the loss of state control. Add to that the fact that they would be an administrative nightmare full of incredibly complex rules and mandates, probably requiring the creation of additional costly state bureaucracy.

You’ll recall that the much ballyhooed (by liberals) decision by the U.S. Supreme Court last summer left it up to the states to decide whether to set up such exchanges.

There are many incentives for states to avoid such exchanges. For starters, they would compete with private insurance and very probably would drive many private insurers out of business. (That’s a strange way to boost the economy, which Obama claims as one of his goals.) Indeed, one of the unstated goals of Obamacare is exactly that: to drive people out of private employer-provided insurance plans and onto the government’s plan. And if the government plan is worse and more expensive than the plan you have? Too bad. Bigger government is always better government. Or so liberals say.

Yes, the federal government can implement exchanges for states like Georgia that refuse to do so — but the divided Congress has not appropriated any funds for them, and is highly unlikely to do so at this point, considering how unpopular Obamacare is.

The original deadline for governors to decide whether to create such exchanges was Nov. 16. But the response has been such a belly-flop that Health and Human Services Secretary Kathleen Sebelius has now extended the deadline to Dec. 14. In other words, an extra month of arm-twisting by Team Obama.

Gov. Deal should stick to his original decision, thereby helping shift the burden and costs of the exchanges back on the administration that passed the law.

Setup exchanges? Conforming to federal govt guidelines? To make everyone conform to a govt controlled healthcare system and run private HC biz out...once this is all over, we will all wait several hours at the govt Dr's office whiles we wait for the allotted dosage of aspirin to be delivered by UPS which has also been taken over by govt...ya volt comrades!

What is being unstated by this editorial - but is obvious - is that the holdout states are hoping that by not participating, they can keep ObamaCare from being implemented and eventually get it overturned. That is extremely unlikely to happen. Not impossible, but just extremely unlikely. The upshot is that if the "massive resistance" to ObamaCare ultimately fails, the holdout states will be behind the curve, and will go running to the federal government at that point begging for permission to set up the exchanges anyway.

This is the funniest part: "“I would support a free market-based approach that could serve as a useful tool for Georgia’s small businesses, but federal guidelines forbid that." So, why didn't Deal advocate such an approach for all those years that he was in Congress? Deal was in Congress from 1993-2010. Nearly all that time the GOP controlled Congress, and for a huge chunk of it the GOP controlled Congress and the White House. None of these great GOP alternatives for ObamaCare were ever proposed, by deal or anyone else. Except, that is, Mitt Romney, who implemented basically the same thing as did Obama on the state level.

Man Up is right. Georgia lost. Obamacare is here to stay. But Deal is right, too. They're imposing it on us, so let the federal government pay for it. The governor is, after all, within the law. So THEY can "man up." Whatever.

Your right but we still have to pay for it. I am in favor of a VAT tax which would tax everyone when they purchase merchandise. That is how it is done in the rest of the world so if you want socialized medicine you need to Man up and pay for it.

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